By Executive Director, Tammy C. Yates
Today is World Hepatitis Day (WHD) and this year’s theme is Eliminate Hepatitis.
According to the World Health Organization (WHO), over 300 million people around the world live with hepatitis. There are 5 main hepatitis viruses, referred to as types A, B, C, D and E. These 5 types are of great concern because of the burden of illness and death they cause and the potential for outbreaks and epidemic spread. In particular, types B and C lead to chronic disease in hundreds of millions of people and, together, are the most common cause of liver cirrhosis and cancer.
In Canada, an estimated 220,697 to 245,987 Canadians live with chronic hepatitis C
(PHAC, 2014) and between 3,200 to 5,000 people are newly infected every year. The WHO estimates that approximately 90% of people living with hepatitis B and 80% living with hepatitis C (HepC) are not aware of their status. This can result in the real possibility of developing fatal liver disease at some point in their lives and in some cases, unknowingly transmitting the infection to others.
With the availability of effective vaccines and treatments for hepatitis B and a cure for HepC, the elimination of viral hepatitis is achievable, but greater awareness and understanding of the disease and the risks is a must, as is access to cheaper diagnostics and treatment.
Here at home, we’ve had some good news about the availability of HepC treatments. In February of 2017, a group called the pan-Canadian Pharmaceutical Alliance (pCPA) negotiated a drug-pricing agreement with several pharmaceutical companies on behalf of the provinces and territories. This resulted in a deal that lowered prices for six HepC medications. After the deal concluded, it was up to the provinces and territories to decide to alter their drug formularies. Alberta, British Columbia, Nova Scotia, Ontario, Quebec and Saskatchewan moved quickly to change their drug formularies to increase access. Even better, British Columbia and Ontario are planning to remove all restrictions to HepC treatment in 2018 (CATIE, 2017).
It’s not all coming up roses just yet! We still don’t have a national HepC strategy and action plan and an estimated 40% of people in Canada who have HepC don’t even know they have it. In Canada, the highest rates of HepC are in marginalized populations such as Aboriginal, immigrant and injection drug user populations (Minuk, G.Y., et al, 2003). Populations with HepC are vulnerable to other STBBIs, tuberculosis, addictions and mental health issues due to common risk factors and inequities in the social determinants of health (Wilson, M., et al, 2009). Vulnerable populations have less access to education and care so they are hard to reach, engage and retain in care (Patrick, D.M., et al. , 2000).
With the inclusion of viral hepatitis in the United Nations Sustainable Development Goals and the recent adoption of the world’s first global hepatitis strategy, we are at a pivotal moment. Now more than ever political commitment is needed. Without urgent action, deaths will continue to rise and the epidemic will continue to grow.
On this WHD, let’s spread the word, it’s time to #Eliminate Hepatitis. All of us at Realize continue to commit to doing our part. Do you?